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1063089241

NPI Code Detail

MEDICARE: DR. BENJAMIN MICHAEL WILKINSON MD

MEDICARE: DR. BENJAMIN MICHAEL WILKINSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	MD-53326	IA
2	207P00000X	Emergency Medicine Physician	MD-53326	IA
3	207P00000X	Emergency Medicine Physician	036176769	IL

General Provider Information

NPI Number	:	1063089241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN MICHAEL WILKINSON MD

Provider Business Mailing Address
First Line	:	4708 CRESTED BUTTE TRL
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61114-7327
Country	:	US
Telephone Number	:	319-899-8161
Fax Number	:	319-384-9393

Provider Business Practice Location Address
First Line	:	1000 MINERAL POINT AVE
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53548-2940
Country	:	US
Telephone Number	:	608-756-6868
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2021
Last Update Date	:	04/01/2026

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Directions to “ DR. BENJAMIN MICHAEL WILKINSON MD” Practice Location

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